Free needles are available at the Needle Exchange Program in Scott County, the first to start such a program in Indiana, in 2015 Scott County was responding to an HIV outbreak linked to intravenous drug use. Tippecanoe County is aiming to do a similar program to deal with a rise in hepatitis C cases linked to drug use.(Photo: Kelly Wilkinson/IndyStar)

Here’s just one more scene from Tippecanoe County’s growing heroin and opioid problem.

A flushed Lafayette Mayor Tony Roswarski found his way out of the County Office Building’s Tippecanoe Room, minutes after county commissioners gave their blessing to a proposed needle exchange, looking like a man clearly outnumbered.

After more than an hour of testimony from addiction counselors, doctors, pharmacists, faith leaders and family members of sons and daughters lost – all packing the room in support of a needle exchange program aimed at minimizing the infectious illness risks tied to heroin use – Roswarski found himself nearly alone and a bit trapped.

Alone, because amid the legitimate discussion about how needle exchanges offer inroads to get addicts help they need, Roswarski’s voice was one of the few looking for more proof that the sort of needle exchange program allowed by the state would actually do all that doctors and counselors said it would.

Trapped, because Roswarski knew how callous his primary question would sound in a community where signs show addiction on the rise: Should he assume a needle exchange naturally would land in one of Lafayette’s core neighborhoods?

Put another way: Should he assume everyone in the room thought that’s what would happen?

The meeting ended with a 2-1 vote in favor of a needle exchange, but without firm word on where one would go. Dr. Jeremy Adler, Tippecanoe County’s health officer who pushed for a needle exchange as a way to stay ahead of a rise in hepatitis C cases, said sites were in negotiation.

But as Roswarski pushed his way out a side door, he was muttering out loud about what was coming next.

In the hallway, he stopped in front of the first physician he came across. In this case, it was Dr. James Bien, vice president of quality and patient safety at IU Health Arnett. During his three minutes of public comment in front of the county commissioners, Roswarski had called Bien his friend – a point a smiling Bien said he appreciated as the mayor came his way in the hallway.

Roswarski was measured, but laid into him, just the same.

“We’ve got all we can handle,” Roswarski told Bien. “All the doctors are for it. So are the hospitals. It would be great if it was hosted at a medical facility as a public health issue. That’s what everybody’s telling me (this is).”

Bien didn’t flinch as the mayor called out the hospitals in general and IU Health Arnett Hospital on Lafayette’s east side in particular.

“I appreciate the mayor raising the question, because I think there’s more opportunity for local health care providers to partner with other service agencies and with community leadership to tackle some of these significant problems,” said Bien, who was one of several IU Health Arnett officials to testify for a needle exchange.

“So I don’t shy away from the call to action,” Bien said. “This has to be more than one structure’s responsibility to respond than city government or county government. It’s going to take a partnership of many. I think we heard that today.”

Would a hospital be the right spot? Bien said he’d carry the mayor’s concerns back to the hospital.

Later this week, Roswarski was still stewing.

A few emails he said he received after Monday’s meeting didn’t help. The upshot of those, by Roswarski’s account: This has nothing to do with you. It’s got nothing to do with the police department. It’s simply a public health issue. It’s not your expertise. Stay out of it.

“I want people to get treatment, don’t get me wrong. Come on, you know me,” Roswarski said. “But I take a little bit of an issue with the people, in a polite way, who say this is just a public health issue. … If it’s an overdose in the ER or medical runs or whatever, we’re involved and co-mingling public health and public safety every single day. We’re in this. In a big way.”

Roswarski and his police chief, Pat Flannelly, have spent considerable time over the past year or so trying to persuade neighborhoods and faith leaders and businesses that drug-induced crime rates is an all-hands-on-deck matter. The mayor’s suggested mantra for all involved, first uttered in fall 2015: “Not in my neighborhood, not in my city.”

Roswarski and Flannelly say they worry about attracting crime, no matter where a needle exchange goes. They say they worry that wherever Tippecanoe County’s needle exchange lands it will become a regional hub, given that state law prohibits asking for IDs from those who use one.

“Nobody is disputing we have a drug problem,” Roswarski said. “But nobody is also disputing that the people on those drugs, to get money to get drugs, commit a substantial amount of the crime our officers are dealing with.”

Two sites have been discussed, Roswarski said. He doesn’t like either one.

The first: the Tippecanoe County Health Department on North Sixth Street.

“It’s right next to Centennial Park. It’s right next to the YWCA,” Roswarski said. “I’m just going to be honest with you. We’re working so hard to turn the Centennial neighborhood around.”

The second: the Howarth Center, a clearinghouse for nonprofit agencies on North 18th Street, a block south of Union Street.

“It took us almost a year and a half of police officers working overtime to get things right over there,” Roswarski said. “We had fights there. We had stabbings there. We had people having inappropriate sexual activity up behind it in the (Murdock Park) woods near Murdock School. There were camps set up there. It took a long time to get that under control. Now to send another potential program out there ... I just don’t know.”

He paused and then echoed what he’d told Bien early: “There is a limit to what we can do and what we can handle.”

Adler and others in the health care community laid out a persuasive case that Tippecanoe County is facing an epidemic if it didn’t get ahead of the infections caused by shared needles. “Harm reduction,” is how Adler put it.

Commissioner Tracy Brown, a former sheriff, said he’d been a hard sell on the idea, even after a year of watching overdose numbers collected by the hospitals and the coroner. He said he shared many of Roswarski’s reservations.

“My question is, if not now, when?” Brown said. “What does the number have to be before we move to action?”

“I’m out in the country – five miles from town,” Byers said. “And I can find needles lying in the ditches. I can find needles all over the place.”

This problem is everywhere.

Tippecanoe County, in line to be the ninth Indiana county with a needle exchange, can’t ignore it. It can’t afford to pretend a doubling of hepatitis C cases since 2013 will take care of itself.

And it can’t assume this county is above Scott County in southern Indiana, the impetus for needle exchanges in the state and where needle sharing was blamed for 207 new cases of HIV infection. (Of those, 80 percent also were infected by the hepatitis C virus. “We’re not seeing HIV cases,” Adler said. “Yet. I have to emphasize ‘yet.’ Our hepatitis C cases are a warning of what’s coming if we don’t act.”)

Roswarski’s question stands, though: Who is in the best position to handle the logistics? Does it need to be Lafayette neighborhoods already shouldering their share of social service obligations? Or can one of Lafayette’s hospitals step into the void, if this is a health crisis and not a public safety issue?

Who said dealing with heroin and everything it brings was going to be easy? Monday was just one more scene in a play that everyone in that room agreed wasn’t going to end soon.

Bangert is a columnist with the Journal & Courier. Contact him at dbangert@jconline.com. Follow on Twitter: @davebangert.